替米沙坦对高血压病人胰岛素抵抗的影响_医学论文.docVIP

替米沙坦对高血压病人胰岛素抵抗的影响_医学论文 替米沙坦对高血压病人胰岛素抵抗的影响_医学论文 【摘要】 目的 比较替米沙坦和氯沙坦对高血压病人胰岛素抵抗的影响。方法 42例高血压病人经过4周单盲安慰剂导入期后被随机分为2组,实验组给予替米沙坦80 mg,每天1次,对照组给予氯沙坦50 mg,每天1次,疗程8周比较两组病人治疗前后空腹血糖、空腹胰岛素和胰岛素敏感指数的变化。结果 两组病人治疗前后空腹血糖变化无统计学差异,实验组治疗后空腹胰岛素和胰岛素敏感指数与治疗前比较差异有统计学意义(0.01)对照组治疗后空腹胰岛素和胰岛素敏感指数与治疗前比较差异无统计学意义(Pgt0.05)实验组治疗前后空腹胰岛素和胰岛素敏感指数变化值与对照组比较差异有显著性(t=6.59、6.98,0.01)。结论 治疗剂量替米沙坦具有提高高血压病人的胰岛素敏感指数,改善高血压病人胰岛素抵抗的作用。 【关键词】 高血压替米沙坦胰岛素抵抗 ［ABSTRACT］ Objective To compare the efficacy of telmisartan with losartan in insulin resistance in hypertensive patients. Methods After four weeks of single-blind placebo transduced period,42 hypertensive patients were randomly divided into experimental group (telmisartan 80 mg, once per day), and control group (losartan 50 mg, once per day), for eight weeks for both groups. Fasting blood glucose (FBG), fasting insulin (FINS), insulin sensitivity index (ISI) were evaluated at the end of therapy. Results The difference of FBG before and after treatment was not significant in both groups. The differences of FINS and ISI before and after treatment were statistically significant (0.01) there was no statistical significance in changes of FPG in both groups, while the change of FINS and ISI were significantly different in the experimental group than that in the control (t=6.59,6.980.01). Conclusion Therapeutic-dose telmisartan offers effect of increasing insulin sensitivity index and improving insulin resistance in the hypertensive. ［KEY WORDS］ Hypertension Telmisartan Insulin resistance 血管紧张素Ⅱ受体抑制剂(ARB)是临床上常用的抗高血压药物之一，在JNC7、ESC/ESH和中国高血压指南中均将ARB确定为一线降压药。本研究通过观察高血压病人替米沙坦和氯沙坦治疗前后空腹血糖（FBG）、空腹胰岛素(FINS)和胰岛素敏感指数(ISI)的变化，探讨两种药物对高血压病人胰岛素抵抗的影响。 1 对象与方法 1.1 研究对象 选择2007年8～11月在我院门诊及住院治疗的轻中度原发性高血压病人42例，男25例，女17例；年龄50～70岁。所有病人收缩压为18.67～23.87 kPa，舒张压为12.00～14.53 kPa。排除近期使用过胰岛素或口服抗糖尿病药物者，未控制的糖尿病(糖化血红蛋白≥7%)，肝功能或肾功能损害者，药物滥用者，充血性心力衰竭者，确诊或可疑继发性高血压者，过去3个月发生脑血管意外或急性冠状动脉综合征者，有用药指征的异常脂蛋白血症者，替米沙坦或氯沙坦治疗禁忌证者。所有病人实验前签订知情同意书。本文42例病人经过4周单盲安慰剂导入期后被随机分为两组。两组病人年龄、性别、病程及基础心脏病构成差异无统计学意义(P